Last updated: March 2021
Suggested citation: van der Sterren, A, Greenhalgh, EM, Knoche, D, & Winstanley, MH 8.15 The role of health workers and community organisations. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021. Available from: http://www.tobaccoinaustralia.org.au//chapter-8-aptsi/8-15-the-role-of-health-workers-and-community-organisations
Smoking cessation support is available to Aboriginal and Torres Strait Islander peoples through a variety of health and community service contexts, including Aboriginal community controlled health services, pharmacies, and general practitioners. Recent developments in Aboriginal health policy and funding have been strategically directed within these sectors to address chronic diseases and risk factors such as smoking.1, 2
This section will summarise evidence on the role of:
- Health services, particularly Aboriginal community controlled health services
- Aboriginal health workers
- Brief interventions delivered by health professionals, and
- Remote community shops
in supporting and promoting cessation among Aboriginal and Torres Strait Islander peoples.
8.15.1 Roles of health services
Many Aboriginal and Torres Strait Islander peoples access healthcare primarily through Aboriginal community controlled health services. These organisations are largely governed and managed by Aboriginal and Torres Strait Islander people from the local community, and employ Aboriginal health workers to assist in the delivery of holistic, comprehensive, and culturally relevant healthcare. Aboriginal community controlled health services have an important role to play in implementing smoking cessation activities, but the nature of these activities, and their capacities to deliver them, vary from location to location. Smoking cessation programs may include: clinical level activities such as brief interventions, nicotine replacement therapy provision and support programs; and preventive activities within the health services, such as health education, social marketing, and the development of supportive workplace policies. Staff from Aboriginal community controlled health services may also become involved with supporting broader community-level initiatives, such as developing local social marketing campaigns, policies around smokefree community areas, or programs delivered through schools, stores or other organisations. Many health services are also specifically implementing programs and activities to support their staff to quit smoking (see Section 220.127.116.11).
A number of studies have documented the service capacity issues faced in delivering tobacco control programs within Aboriginal community controlled health services.3-7 Traditionally, many health services have found it difficult to prioritise tobacco control as there are so many other competing and immediate health and social issues; service delivery have often placed a disproportionate focus on acute biomedical healthcare rather than on preventive healthcare.3, 4, 6 Some health workers report that there is not enough time to build relationships with patients that are sufficiently robust to enable them to raise what they see as sensitive and confronting lifestyle issues (such as smoking).6 Health service staff involved in one study suggested adult health checks as an enabler to conducting brief interventions, but several services in this study had found it difficult to incorporate adult health checks into their work practice.6 Other service capacity issues include: the capacity (particularly time and resources) to provide and support adequate training;3, 6 high staff turnover and difficulty retaining skilled staff;4, 6, 7 inadequate resourcing to sustain activities;7 lack of infrastructure to adequately provide programs;6 and lack of follow-up services to which to refer patients.5
Taking a team approach to healthcare delivery,3 and strong and consistent leadership6 have been recognised as enablers to implanting cessation interventions. One study found that where the community is ‘ready’ to respond to smoking—i.e. tobacco control has been identified as a priority, key stakeholders are mobilised, and staff have been made available to implement activities—tobacco control activity is more likely to occur.7 Indeed, national surveys of Aboriginal community-controlled health services (ACCHS) in 2012–13 found that most prioritised tobacco control “a great deal” or “a fair amount”, and this translated to smokefree policies, staff training in tobacco control, extra smoking cessation support for staff, and the provision of a range of quit-smoking information and activities for clients and the community.8
While Aboriginal community controlled health services are central in the delivery of healthcare to Aboriginal and Torres Strait Islander peoples, many Indigenous people will access mainstream services—i.e. those without Indigenous structures of governance. The effectiveness of such services may be limited by factors such as cost, reduced cultural safety, language barriers, and racism (whether perceived or actual). It is crucial that mainstream services are well equipped, through appropriate training, funding, and referral relationships, to work with Aboriginal and Torres Strait Islander clients. For example, the Practice Incentives Programs Indigenous Health Incentive provides financial incentives for general practices to manage complex chronic disease issues for Aboriginal and Torres Strait Islander patients, and the Pharmaceutical Benefits Scheme Co-payment Measure enables the subsidisation of medications (including nicotine replacement therapy and other pharmacotherapies) for the prevention or management of chronic diseases.9 Hospitals can also provide support to Aboriginal and Torres Strait Islander inpatients who have been identified as smokers, for instance by informing them of the hospital’s smokefree policy, advising and supporting them with options for managing nicotine withdrawal during their stay, and offering them further support after discharge.10 High-intensity cessation support has been found to result in higher quit rates in other populations,11 and could also be successful for Aboriginal and Torres Strait Islander peoples.12
8.15.2 Roles of Aboriginal health workers
Aboriginal health workers are critical to the delivery of primary healthcare interventions and therefore play an important role in addressing smoking in communities. However, they face very particular challenges in delivering tobacco action activities. Such workers often come from and reside in the communities where they work.13 Since they are part of the same social context as their client base, it is not surprising that they also have comparatively high smoking rates (see Section 8.3.4). The nature of the work and the workload is also stressful, given that they are immersed in communities with high health and welfare needs, operate within time and resources constraints, and have specific social expectations placed upon them by family and community members.14 The stress and grief that accompanies their work makes it more difficult for Aboriginal health workers who smoke to quit themselves,15 and also provides a challenging work environment within which to deliver smoking cessation activities.
Studies report varying rates of Aboriginal health workers asking clients about their smoking status and talking to clients about cessation. One Western Australian study of 36 Aboriginal health workers reported that one-third asked all of their clients if they smoked, but just over a quarter asked none.16 In a New South Wales study involving 98 Aboriginal health workers, 80% reported providing quit smoking advice in their professional capacity.17 However, while most Aboriginal health workers in a qualitative study in Western Australia (n=10) reported routinely asking their pregnant clients if they smoked, very few followed this up with specific cessation advice.5 Another study with Aboriginal and Torres Strait Islander pregnant women found that while most had been asked by a health worker during their antenatal care if they smoked (95%), fewer had been given advice to stop smoking (83%), and even fewer had been offered support to stop smoking (65%).18 The National Aboriginal and Torres Strait Islander Tobacco Control Project also found that fewer than half of surveyed health staff reported that they had discussed tobacco with clients.19 More recently, among a national sample of Aboriginal and Torres Strait Islander smokers and recent ex-smokers surveyed in 2012–13, almost all daily smokers who had seen a health professional in the year prior recalled being asked if they smoke, and three quarters were advised to quit. This advice was associated with making a quit attempt.20
Aboriginal health workers may face a range of barriers that hinders their capacities to provide smoking cessation advice, which include high prevalence rates, community attitudes to smoking, and their levels of confidence, knowledge and skills to deliver tobacco control activities. The lower relative priority of smoking when compared to other more urgent health and social issues affecting clients’ lives (including from other more immediately damaging alcohol and drug misuse) affects the extent to which health workers prioritise smoking cessation in the clinical context, and their capacity to undertake preventive activities in tobacco control.4, 5, 17 Looking from the perspective of the client rather than the health worker, The Forgotten Smokers reported that smokers felt they had limited access to health workers, and that health workers were generally too busy caring for people with acute health problems to have the time to talk about smoking.21 The need for a specialised tobacco action workforce is widely recognised as a way to improve the capacity of services to deliver tobacco action activities,3, 22, 23 and forms the backbone of the response under the Tackling Indigenous Smoking program.2
There is a consistent view across various geographical settings that high rates of smoking among Aboriginal health workers may affect their confidence and capacity to offer smoking cessation advice to their clients.4, 13, 16, 17, 24, 25 A small Western Australian study reported that compared with Aboriginal health workers who smoke, those who are non-smokers and ex-smokers are more likely to advise smokers to quit and to provide warnings about the detrimental health effects of smoking.16 Similarly, a national survey of staff of Aboriginal community-controlled health services found that ex-smokers were most likely to report being confident in talking to others about smoking and quitting.26
Health workers who smoke may feel hypocritical or as though they lack credibility when providing cessation advice, particularly if they have unsuccessfully attempted to quit.24, 25 Aboriginal health workers have reported that if they could quit themselves, they would feel more confident speaking to community members about quitting.25 They have also expressed desire for support in the workplace to quit, such as nicotine replacement therapy, quit groups and quit buddies.25 However, research from New South Wales has shown that some health workers who were non-smokers also felt uncomfortable discussing smoking, since they lacked personal experience of tobacco addiction and making quit attempts.17 Another study in Western Australia reported that two non-smoking Aboriginal health workers (of 36 total participants) felt uncomfortable talking to clients about cessation as they worked with colleagues who smoked and so did not want to appear hypocritical by association.16
Aboriginal health workers (whether smokers or non-smokers) have also expressed concern that discussing smoking cessation could be perceived by their clients as judgemental and moralising.4, 5, 16, 27 Health workers have reported being concerned about making their clients feel badly about themselves by raising smoking cessation, particularly when so many other health and social issues are affecting them.4, 5 Some Aboriginal health workers have reported discomfort at providing smoking cessation advice to elders or respected family members,3, 4, 16, 28 and some are also worried that raising smoking will damage the therapeutic relationship and discourage patients from returning for ongoing healthcare.5, 6 They have reported attenuating this discomfort by using less confrontational strategies for talking to people about smoking, including speaking about the general effects or talking about reducing passive smoking around children.5 However, while Aboriginal health workers have these concerns, their clients do not necessarily agree. One study with pregnant Aboriginal and Torres Strait Islander women in New South Wales found that 80% of the women thought that healthcare workers should advise pregnant women to quit.18 There is also strong support among Aboriginal communities for smokefree Aboriginal community-controlled health services, with national surveys showing that 87% of non-smokers, 85% of ex-smokers, and 77% of daily smokers support a complete ban on smoking inside and around the buildings.8
Studies and workshops examining workforce issues in Aboriginal and Torres Strait Islander tobacco control cite lack of knowledge, skills and training as other reasons for not providing information to promote quitting.4, 16, 17, 19, 21, 27, 29-34 While smoking is part of the competencies in Aboriginal health worker training, how this is actually taught varies from provider to provider. A survey of training providers found that most taught general information about tobacco use, but few provided skills-based training in facilitating quit groups or in using nicotine replacement therapy. Additional resources were needed for both Aboriginal health workers and the trainers.33 Another study supports this finding that training should cover more than simply brief interventions, and include information about addiction, motivational interviewing and the use of pharmacotherapies.16 Aboriginal and Torres Strait Islander-specific packages to deliver brief intervention training have been developed, and other training packages and toolkits have been developed around the country.34, 35
8.15.3 Brief interventions and brief intervention training
Brief interventions delivered by health professionals are effective in reducing smoking prevalence in various mainstream settings,36-38 and are quick, inexpensive and non-invasive to deliver.39 There have been no studies specifically evaluating the efficacy of brief interventions delivered to Aboriginal and Torres Strait Islander peoples, particularly when delivered by Aboriginal health workers. A number of evaluations have included brief interventions or individual counselling as part of the overall delivery of treatment,40, 41 but it is difficult to assess the contribution of brief interventions to cessation rates. A qualitative study involving interviews with 25 residents of remote Northern Territory communities reported that for those with a smoking history (15 current smokers, six ex-smokers, two recently quit smokers) brief interventions from Aboriginal health workers were influential in their decision to quit, particularly when provided in the context of acute health events.3
In mainstream settings, training health professionals in providing smoking brief interventions has been shown to have a measurable effect on their professional practice; they are more likely to identify smokers and to provide them with smoking cessation advice than untrained professionals.42 Even when doctors merely provide brief, simple advice about quitting, this increases the likelihood a smoker will successfully quit and remain a non-smoker 12 months later.43
In Aboriginal and Torres Strait Islander contexts, training programs such as SmokeCheck have been rolled out in several states to address the lack of skills and confidence that health workers may face in delivering smoking cessation advice and tobacco programs . SmokeCheck has been adopted in Queensland, New South Wales, South Australia and Western Australia, and evaluated in Queensland and New South Wales.27, 44 The evaluation of the New South Wales SmokeCheck program found that there were significant increases in the confidence of health workers to talk to their clients about the health effects of smoking, raise ‘quitting’ with clients making health visits for unrelated reasons, assess clients’ stage of change for smoking cessation/readiness to quit, and raise smoking as a point of discussion with clients. In addition, there were increases in the number of health workers who provided advice about nicotine replacement therapy, secondhand tobacco smoke, and cutting down tobacco use. More Aboriginal health workers recognised the importance of offering smoking cessation advice to their clients after the training, and perceived that it was easier to offer this advice after having received the training. The number of Aboriginal health workers living in smokefree homes increased during the project, as did the availability of culturally appropriate written resources to support clients to quit.44 Similarly, evaluations of the use of SmokeCheck in Queensland4, 27, 40 and New South Wales45 found that health workers were satisfied with the training, that it increased their confidence to deliver smoking cessation advice appropriately, and that it improved their clinical practice. However, one study found that six months after their training, most health workers failed to deliver the intervention as intended due to perceived challenges in working in remote Indigenous communities.4 Similarly, follow up interviews with health workers trained in SmokeCheck in remote North Queensland indicated that while they felt positive about the training, they did not use brief interventions in the manner in which they had been trained, reporting instead that they adapted and used only some of the components.46
While SmokeCheck training may have benefits for practitioners who smoke, its effectiveness in improving smoking cessation rates for patients is not yet clear. One study of the South Australian SmokeCheck program that has followed up clients at three and six months appears to have encouraged quit attempts, but the numbers are too small to make definitive statements about the success of this program.47 In a study evaluating the impact of a SmokeCheck pilot program in Queensland, there was no evidence that any patients or practitioners had given up smoking after six months.4 The remote North Queensland research mentioned above implemented SmokeCheck (albeit inconsistently) as part of a comprehensive tobacco control program, which overall resulted in a decline in consumption among Indigenous communities.46
Quit Victoria has also been involved in developing and delivering educator training to Aboriginal and Torres Strait Islander communities in Victoria and the Northern Territory. This two-day training program provides general information and brief intervention training, and notably presents this in an interactive way to promote participants to think about and problem solve the challenging situations in which they may find themselves.28 Quit South Australia has been funded by the Commonwealth government as part of the Tackling Indigenous Smoking program to provide a number of different smoking cessation training courses (Quitskills and Motivational Interviewing) to health workers who work with Aboriginal peoples and Torres Strait Islanders.48 While these programs may be successful in improving health worker confidence to talk to clients about smoking cessation, the impacts on actual smoking rates, as with the SmokeCheck program, are not known.
8.15.4 Role of remote community shops
As part of the 1999–2000 evaluation of a Northern Territory tobacco action project, researchers assessed the potential role of remote community stores to be involved in health promotion programs around tobacco action. Findings from the study suggest that community shops serving remote communities may potentially assist in tobacco control by supporting community tobacco action programs, through displaying or providing anti-tobacco health promotion materials, implementing smokefree policies, and providing staff with training to deliver cessation advice. Pricing policies adopted by community stores may also affect tobacco sales, although this is an area requiring further research.49 One study examined the effects of “income management” on sales of tobacco in 10 remote Aboriginal and Torres Strait Islander communities in the 18 months before and after the introduction of the Northern Territory Emergency Response. Income management strategies restrict the purchase of certain products, including cigarettes and tobacco, on 50 per cent of welfare recipients benefits aiming to encourage the sale of healthy food. The Income Management evaluation found no beneficial effect in terms of sustained change in the sales of healthy food, soft drink or tobacco resulting from the strategy. It did, however, find that there was a marked increase in all store sales with the government stimulus package. These findings suggest that income management alone will not lead to modification of spending patterns.50
Relevant news and research
For recent news items and research on this topic, click here. ( Last updated March 2021)
1. Department of Health and Ageing. The Indigenous chronic disease package—fact sheet. Canberra, Australia: Department of Health and Ageing, 2010.
2. Department of Health and Ageing. National action to reduce Indigenous smoking rates—Fact Sheet. Canberra: Department of Health and Ageing, 2010.
3. Johnston V and Thomas D. What works in Indigenous tobacco control? The perceptions of remote Indigenous community members and health staff. Health Promotion Journal of Australia, 2010; 21(1):45–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20406152
4. Harvey D, Tsey K, Cadet-James Y, Minniecon D, Ivers R, et al. An evaluation of tobacco brief intervention training in three indigenous health care settings in north Queensland. Australian and New Zealand Journal of Public Health, 2002; 26 (5):42 6–31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12413286
5. Wood L, France K, Hunt K, Eades S, and Slack-Smith L. Indigenous women and smoking during pregnancy: knowledge, cultural contexts and barriers to cessation. Soc Sci Med, 2008; 66(11):2378–89. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18313186
6. Panaretto K, Coutts J, Johnson L, Morgan A, Leon D, et al. Evaluating performance of and organisational capacity to deliver brief interventions in Aboriginal and Torres Strait Islander medical services. Australian and New Zealand Journ al of Pub lic Health, 2010; 34(1):38–44. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20920103
7. Thomas D, Johnston V, and Fitz J. Lessons for Aboriginal tobacco control in remote communities: an evaluation of the Northern Territory 'Tobacco Project'. Australia and New Zealand Journal of Public Health, 2010; 34(1):34–45. Ava ila ble fr om: http://www.ncbi.nlm.nih.gov/pubmed/20920104
8. Davey ME, Hunt JM, Foster R, Couzos S, van der Sterren AE, et al. Tobacco control policies and activities in Aboriginal community-controlled health services. Medical Journal of Australia, 2015; 202(10):S63–6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26017260
9. Department of Health and Ageing. Accessing the PBS co-payment measure. Closing the Gap: tackling Indigenous chronic disease. Canberra, Australia: Department of Health and Ageing, 2010. Available from: https://www.pbs.gov.au/info/publication/factsheets/closing-the-gap-pbs-co-payment-measure.
10. Ivers RG. Tobacco and aboriginal people in NSW. N S W Public Health Bull, 2008; 19(3-4):65–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18507969
11. Rigotti N, Munafo M, Murphy M, and Stead L. Interventions for smoking cessation in hopsitalised patients. Cochrane Database of Systematic Reviews, 2001; (3):CD001837. DOI: 10.1002/14651858.CD001837.pub2. Available from: http://www2.cochrane.org/reviews/en/ab001837.html
12. Briggs VL, Lindorff KJ, and Ivers RG. Aboriginal and Torres Strait Islander Australians and tobacco. Tobacco Control, 2003; 12 Suppl 2(suppl. 2):ii5–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12878767
13. Thompson M, Robertson J, and Clough A. A review of the barriers preventing Indigenous Health Workers delivering tobacco interventions to their communities. Australian and New Zealand Journal of Public Health, 2011; 35(1):47–53. Ava ilable from: https://www.ncbi.nlm.nih.gov/pubmed/21299700
14. Genat B, Bushby S, McGuire M, Taylor E, Walley Y, et al., Aboriginal healthworkers: primary health care at the margins. Crawley, Australia: University of Western Australia Press; 2006. Available from: http://books.google.com/books?id=rjvfP5h51MkC.
15. Dawson AP, Cargo M, Stewart H, Chong A, and Daniel M. Aboriginal health workers experience multilevel barriers to quitting smoking: a qualitative study. International Journal for Equity in Health, 2012; 11:27. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22621767
16. Pilkington AAG, Carter OBJ, Cameron AS, and Thompson SC. Tobacco control practices among Aboriginal health professionals in Western Australia. Australian Journal of Primary Health, 2009; 15(2):152–8. Available from: http://www.publish.csiro.au/?paper=PY08066
17. Mark A, McLeod I, Booker J, and Ardler C. Aboriginal health worker smoking: a barrier to lower community smoking rates? Aboriginal and Islander Health Worker Journal 2005; 29(5):22–6. Available from: http://search.informit.com.au/documentSummary;dn=132032641548770;res=E-LIBRARY
18. Passey M, Gale J, Stirling J, and Sanson-Fisher R, Tobacco, cannabis and alcohol: changes in pregnancy among Aboriginal women in NSW. Primary Health Care Research Conference Adelaide: Flinders University Primary Health Care Research & amp ; Info rmation Service; 2010. Available from: http://www.phcris.org.au/download.php?id=6874&spi=3.
19. Lindorff KJ. Tobacco time for action: National Aboriginal and Torres Strait Islander Tobacco Control Project final report. Canberra, Australia: National Aboriginal Community Controlled Organisations, 2002.
20. Thomas DP, Bennet PT, Briggs VL, Couzos S, Hunt JM, et al. Smoking cessation advice and non-pharmacological support in a national sample of Aboriginal and Torres Strait Islander smokers and ex-smokers. Medical Journal of Australia, 20 15; 202(1 0):S73–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26017262
21. Stewart I and Wall S. The forgotten smokers. Aboriginal smoking: issues and responses. Commissioned by the Australian Medical Association and Australian Pharmaceutical Manufacturers' Association. Canberra: Australian Medical Associati on, 2000 Available from: http://ama.com.au/node/778
22. Centre for Excellence in Indigenous Tobacco Control. Indigenous tobacco control in Australia: everybody's business. National Indigenous Tobacco Control Research Roundtable report. Melbourne, Australia: CETIC, The University of Melbour ne, 2008 Available from: https://healthbulletin .or g.au/a rticles/indigenous-tobacco-control-in-australia-everybodys-business-national-indigenous-tobacco-control-research-roundtable-report/
23. Centre for Excellence in Indigenous Tobacco Control. Learning from each other. in Oceania Tobacco Control 09 Indigenous Pre-Conference Workshop. Melbourne, Australia. CEITC, The University of Melbourne; Year.
24. Murphy M and Mee V. Chapter 6: The impact of the National Tobacco Campaign on Indigenous communities: a study in Victoria, in Australia's National Tobacco Campaign: evaluation report vol.1. Hassard K, Editor Canberra: Department of Healt h and Aged Care; 1999.
25. Thompson M. What are Indigenous health workers saying about their smoking status: does it prevent them providing tobacco information and/or quit support to the community? . Aboriginal and Islander Health Worker Journal, 2010; 34(2):3& nda sh;8. Available from: http://search.informit.com.au/documentSummary;dn=941772933641696;res=E-LIBRARY
26. Thomas DP, Davey ME, Panaretto KS, Hunt JM, Stevens M, et al. Smoking among a national sample of Aboriginal and Torres Strait Islander health service staff. Medical Journal of Australia, 2015; 202(10):S85–9. Available from: http://europepmc.org/abstract/MED/26017264
27. Queensland Health. SmokeCheck Evaluation Report 2006. Brisbane: Queensland Government, 2007.
28. Zandes S, Holloway E, and Mason T. Quit Victoria's Darwin and Alice Springs educator training. Aboriginal and Islander Health Worker Journal, 2008; 32(2):16–7.
29. Department of Health South Australia. Indigenous smoking scoping study: prepared for the South Australian Department of Health. Adelaide: Department of Health, 2008. Available from: https://catalogue.nla.gov.au/Record/4469455
30. West L, Young D, and Lloyd J. A report on Far North Queensland Aboriginal and Torres Strait Islander health workers. Knowledge, attitudes and beliefs about smoking cessation and prevention. Cairns: Queensland Health, 1998.
31. Andrews B, Oates F, and Naden P. Smoking among Aboriginal health workers: findings of a 1995 survey in western New South Wales. Australian and New Zealand Journal of Public Health, 1997; 21:789–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9489201
32. Centre for Excellence in Indigenous Tobacco Control. National Indigenous Tobacco Control Research Workshop report. Melbourne, Australia: CEITC, The University of Melbourne, 2007. Available from: https://catalogue.nla.gov.au/Record/4318462
33. Adams K and Walker H. Smokes and Aboriginal Health Worker Training. Aboriginal and Islander Health Worker Journal, 2006; 30(2):15–6. Available from: http://search.informit.com.au/documentSummary;dn=224526710874475;res=E-LIBRARY
34. Centre for Excellence in Indigenous Tobacco Control, Talkin' Up Good Air: Australian Indigenous Tobacco Control Resource Kit. Melbourne, Australia: CEITC, The University of Melbourne; 2007. Available from: https://tacklingsmoking.org.au/key-resour ces /resou rces/14810/?title=Talkin%27+up+good+air%3A+Australian+Indigenous+tobacco+control+resource+kit.
35. Aboriginal Health and Medical Research Council of NSW, Aboriginal Tobacco Resistance Tool Kit. Sydney NSW 2012. Available from: https://tacklingsmoking.org.au/key-resources/resources/24242/?title=Ab ori ginal% 20tobacco%20resistance%20tool%20kit.
36. Stead LF, Bergson G, and Lancaster T. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews, 2008; (2):CD000165. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18425860
37. Rice VH and Stead LF. Nursing interventions for smoking cessation. Cochrane Database of Systematic Reviews, 2008; (1):CD001188. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18253987
38. Carr AB and Ebbert JO. Interventions for tobacco cessation in the dental setting. Cochrane Database of Systematic Reviews, 2006; (1):CD005084. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16437517
39. Ivers R. Anti-tobacco programs for Aboriginal and Torres Strait Islander people 2011. Produced for the Closing the Gap Clearinghouse. cat. no. IHW 37.Canberra: Australian Institute of Health and Welfare and Melbourne: Australian In stitut e of Family Studies, 2011. Available from: https://www.aihw.gov.au/reports/indigenous-australians/anti-tobacco-pro gra ms-for -aboriginal-and-torres-st/summary
40. Campbell S, Duquemin A, Swinbourne A, and McDermott R. The North Queensland Indigenous Tobacco Project 2003–2006. Adelaide: University of South Australia, 2008.
41. Ivers R, Farrington M, Burns C, Bailer R, D'Abbs P, et al. A study of the use of free nicotine patches by Indigenous people. Australian and New Zealand Journal of Public Health, 2003; 27(5):486–90. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-842X.2003.tb00819.x
42. Carson KV, Verbiest ME, Crone MR, Brinn MP, Esterman AJ, et al. Training health professionals in smoking cessation. Cochrane Database of Systematic Reviews, 2012; (5):CD000214. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22592671
43. Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, et al. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2013 DOI: 10.1002/14651858.CD000165.pub4. Available from: http://dx.doi.org/10.1002/14651858.CD000165.pub3
44. New South Wales Department of Health. Final Report—The NSW SmokeCheck Aboriginal Tobacco Prevention Project 2007–2008. Sydney: NSW Department of Health, 2010. Available from: http://www.health.nsw.gov.au/pubs/2010/smokecheck_report.html
45. Hearn S, Nancarrow H, Rose M, Massi L, Wise M, et al. Evaluating NSW SmokeCheck: a culturally specific smoking cessation training program for health professionals working in Aboriginal health. Health Promotion Journal of Australia, 20 11; 22(3) :189–95. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22497062
46. Campbell S, Bohanna I, McKeown-Young D, Esterman A, Cadet-James Y, et al. Evaluation of a community-based tobacco control intervention in five remote north Queensland Indigenous communities. International Journal of Health Promotion a nd Educat ion, 2014; 52(2):78–89. Available from: http://dx.doi.org/10.1080/14635240.2013.859444
47. Hosking J, Stewart H, and Chong A. SmokeCheck Tobacco Brief Intervention Program: results of client three and six month follow-ups. in Oceania Tobacco Control Conference, Reducing inequality through tobacco control. 2009.
48. Cancer Council South Australia. Smoking cessation training for tackling Indigenous smoking. Available from: https://www.cancersa.org.au/support/aboriginal-communities/healthy-l ife styles /quitskills-smoking-cessation-training/
49. Ivers RG, Castro A, Parfitt D, Bailie RS, Richmond RL, et al. The role of remote community stores in reducing the harm resulting from tobacco to Aboriginal people. Drug Alcohol Rev, 2006; 25(3):195–9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16753641
50. Brimblecombe JK, McDonnell J, Barnes A, Dhurrkay JG, Thomas DP, et al. Impact of income management on store sales in the Northern Territory. Medical Journal of Australia, 2010; 192(10):549–54. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20477726